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Hypermagnesemia in Emergency Medicine Workup

  • Author: Nona P Novello, MD; Chief Editor: Erik D Schraga, MD  more...
 
Updated: Dec 17, 2014
 

Laboratory Studies

Electrolytes, including potassium, magnesium, and calcium levels[6, 7]

  • A test for ionized magnesium is clinically available. However, it is used most often for monitoring magnesium infusions. The serum magnesium level is often used as an initial study in the ED.
  • Elevation in magnesium level is usually not found as an isolated electrolyte abnormality.
  • Hyperkalemia and hypercalcemia are often present concurrently.

BUN and creatinine levels

  • Obtain renal function tests and calculate creatinine clearance to assess the ability of the kidney to excrete magnesium.
  • Serum magnesium levels rise when creatinine clearance is less than 30 mL/min.

Check serum creatine phosphokinase (CPK) level or urine myoglobin level in patients in whom rhabdomyolysis is suspected.

Arterial blood gases (ABG) may reveal a respiratory acidosis.

Thyroid function tests

  • Hypothyroidism is a rare cause of hypermagnesemia.
  • Check these tests in the absence of any other good explanation.
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Other Tests

An ECG and cardiac monitor may show prolongation of the PR interval or intraventricular conduction delay, which are nonspecific findings.

The ECG findings may reflect other electrolyte abnormalities such as hyperkalemia.

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Contributor Information and Disclosures
Author

Nona P Novello, MD Chief Medical Information Officer, MedStar Franklin Square Medical Center

Nona P Novello, MD is a member of the following medical societies: American College of Emergency Physicians, American Association for Physician Leadership, Phi Beta Kappa, Healthcare Information and Management Systems Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Jeffrey L Arnold, MD, FACEP Chairman, Department of Emergency Medicine, Santa Clara Valley Medical Center

Jeffrey L Arnold, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Physicians

Disclosure: Nothing to disclose.

Chief Editor

Erik D Schraga, MD Staff Physician, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates

Disclosure: Nothing to disclose.

Additional Contributors

Joseph J Sachter, MD, FACEP Consulting Staff, Department of Emergency Medicine, Muhlenberg Regional Medical Center

Joseph J Sachter, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Association for Physician Leadership, American Medical Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Acknowledgements

Howard A Blumstein, MD, FAAEM Assistant Professor of Surgery, Medical Director, Department of Emergency Medicine, Wake Forest University School of Medicine

Howard A Blumstein, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Emergency Medicine Residents Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

References
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